Provider Demographics
NPI:1609100718
Name:LUDWIG, JENNIFER
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 S CLARKSON ST
Mailing Address - Street 2:APT. 202
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-2283
Mailing Address - Country:US
Mailing Address - Phone:303-548-0933
Mailing Address - Fax:
Practice Address - Street 1:1313 S CLARKSON ST
Practice Address - Street 2:APT. 202
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-2283
Practice Address - Country:US
Practice Address - Phone:303-548-0933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO256674225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics